This study established an HPLC fingerprint of Tibetan medicine Shaji Gao from different habitats and lay a foundation for Shaji Gao varieties identification and preparation process. The chromatographic condition was as follow: Agilent zorbax SB-C18 (4.6 mm x 250 mm, 5 μm) eluted with the mobile phases of acetonitrile and 0.4% phosphoric acid water in gradient mode. The flow rate was 1.0 mL x min(-1), and the detection wavelength was set at 360 nm. The fingerprints of 15 batches Shaji Gao were carried out by similarity comparation, 7 chromatographic peaks were extracted as the common peaks of fingerprint, 3 peaks were identified, which were quercetin, kaempferol and isorhamnetin. The similarity degrees of 14 batches of samples were above 0.9 and 1 batch of samples was below 0.9. This is the first established fingerprint of Shaji Gao by using HPLC. This method has good precision, stability and repeatability that it could provide basis for quality control and evaluation of Shaji Gao.
Chromatography, High Pressure Liquid ; methods ; Medicine, Tibetan Traditional ; Quality Control

Objective To investigate the frequencies of human leukocyte antigen ( HLA)-DRB1 alleles of Chinese Marrow Donor Program (CMDP) donors in seven markets of Jiangsu Han population. Methods 2787 donors from CMDP Jiangsu Branch were typed in HLA-DRB1 locus using polymerase chain reaction-sequence-based typing (PCR-SBT) method or polymerase chain reaction-reverse sequence specific oligonucleotide probes (PCR-rSSOP) method. Frequencies of HLA-DRB1 were separately calculated in seven markets and a comparison was made among them. Results A total of 38,33,26,36,37,31,26 alleles in DRB1 locus were separately found in Huai-an, Xuzhou, Taizhou, Suqian, Nanjing, Changzhou, Yangzhou population. The most frequent HLA-DRB1 alleles in Huai-an, Xuzhou, Suqian respectively were DRB1 * 07:01, 09:01, 15:01,12:02; In Nanjing and were DRB1 * 09:01,07:01, 15:01, 12:02; In Yangzhou were DRB1 * 09:01,07:01,15:01,08:03; In Taizhou were DRB1 *09:01, 07:01, 04:05, 15:01; In Changzhou were DRB1 *09:01,07:01, 12:02, 08:03. Conclusion The above results reflected the distribution of HLA-DRB1 alleles in seven markets of Jiangsu Han population, which held abundant polymorphism, and a certain uniqueness in every market. The HLA-DRB1 allele distribution of Nanjing, Yangzhou were the closest groups to northern China, Huaian, Xuzhou, Suqian, Changzhou, Taizhou were close to northern China except DRB1 * 09:01,07:01 in different frequencies. These findings could guide the selection of future donor in CMDP Jiangsu Branch. It also could serve as foundation for HLA related disease research, studies of population genetics and anthropology in Chinese Han population.

Objective To observe the preventive effect of Anduolin(ADL) on radiation-induced lung injury in mice.Methods Totally 180 of Kunming mice were randomly classified into six groups:normal control group ( N ),irradiation control group ( R),irradiation plus low dose ADL group ( L),irradiation plus middle dose ADL group ( M),irradiation plus high dose ADL group ( H),and irradiation plus Dexamethasone group (D).The mice except group N were irradiated with 20 Gy of 6 MV X-rays on whole lung.The mice in group L,M and H were given with ADL 1 d before irradiation and continued for 6 weeks after irradiation.At 2,4 and 6 weeks after irradiation,the general situation and the lung pathological changes of mice were observed.The lung wet weight,collagen contents of the whole lung tissue,hydroxproline concentration,and TGF-β1 expression in the lung were also delected.Results Compared to the group R,the mice breathing rate,hydroxproline concentration,and TGF-β1 expression in the group L were not significantly changed.While in the groups M,H and D,the breathing rate,the generation of hydroxproline and the expression of TGF-β1 were decreased significantly ( F =2.668-161.646,P ＜0.05).In addition,ADL alleviated the pathological changes on radiation-induced lung injury in mice.Conclusions ADL might have the preventive effect on radiation-induced lung injury in mice.

Objective To evaluate the effect of electroconvulsive therapy (ECT) on the expression of phosphorylated glutamate receptor 1 (p-GluR1) and Ca2+/calmodulin-dependent protein kinase Ⅱ α (p-CaMK Ⅱ α) under small dose ketamine combined with propofol anesthesia in the depressed rats.Methods Forty healthy adult male Sprague-Dawley rats,weighing 200-250 g,aged 2-3 months,were used in this study.Mental depression was induced by exposing the animals to chronic unpredictable mild stress (CUMS).Forty mentally depressed rats were divided randomly into 5 groups (n =8 each) using a random number table:M0-4 groups.Propofol 80 mg/kg and ketamine 10 mg/kg were injected intraperitoneally in M0-4 groups.After disappearance of righting reflex,M1-4 groups received ECT of 60,120,180 and 240 mC once a day for 7 consecutive days,respectively,by means of a current (frequency 50 Hz,sine-wave,pulse width 0.7 ms,1-s duration) delivered via ear-clip electrodes,while group M0 received ECT of no quantity of electric charge via ear-clip electrodes.Before CUMS,at 1 day after CUMS and at 1 day after ECT,sucrose preference test was applied to evaluate the depressive behavior.The sucrose preference percentage (SPP) was calculated.At 4 days after CUMS and 4 days after ECT,the learning and memory function was assessed using Morris water maze test.The rats were then sacrificed,and hippocampi were isolated to detect the expression of GluR1,p-GluRl,CaMK Ⅱ α and p-CaMK Ⅱ α by Western blot.Results The SPP was significantly lower after CUMS than before CUMS in M0-4 groups (P＜0.05).Compared with that after CUMS,the SPP was significantly increased,the escape latency was shortened,and the space exploration time was prolonged after ECT in M1-4 groups (P＜0.05).There was no significant difference in SPP after ECT between M1-4 groups (P＞0.05).Compared with group M0,the SPP was significantly increased,and the expression of pGluR1 and p-CaMK Ⅱ α was up-regulated in M1-4groups (P＜0.05).Compared with group M2,the escape latency was significantly prolonged,the space exploration time was shortened,and the expression of pGluR1 and p-CaMK Ⅱ α was down-regulated after ECT in the other groups (P＜0.05).There was no significant difference in GluR1 and CaMK Ⅱ α expression after ECT between the five groups (P＞ 0.05).Conclusion ECT can induce cognitive decline when applied for anti-depression under small dose ketamine combined with propofol anesthesia,and the mechanism is related to increased phosphorylation of GluR1 and CaMK Ⅱ α expression in rats.

Objective To evaluate the role of renal cell apoptosis in acute kidney injury (AKI) induced by sepsis in mice. Methods Forty-five male C57BL/6 mice were randomly assigned into 3 groups ( n = 15 each):sham operation group (group S), cecum ligation and puncture group (group CLP) and CLP + caspase-3 inhibitor Ac-DEVD-CHO group (group CI). Intra-abdominal infection was induced by CLP. Ac-DEVD-CHO 4 μg/g was infused subcutaneously 30 min before CLP in group CI. Five mice in each group were sacrificed after collection of blood samples at 6, 12 and 24 h after CLP. The levels of serum blood urea nitrogen (BUN) and creatinine (Cr)were detected. The apoptosis rate and expression of caspase-3 protein and caspase-3 mRNA were determined.Pathological changes in renal tissues were observed with light microscope. Results The serum BUN and Cr concentratiors, apoptosis rate and expression of caspase-3 mRNA and caspase-3 protein were significantly higher in group CLP than in group S, but lower in group CI than in group CLP ( P ＜ 0.05). Light microscopic examination showed that the pathologic changes induced by Ac-DEVD-CHO were less severe in group CI than in group CLP.Conclusion The renal cell apoptosis is one of the mechanism of AKI induced by sepsis.

Abstract： Objective　To investigate and analyze the factors influencing the direct medical costs of tuberculosis patients in Hainan Province, so as to provide scientific reference for reducing the medical burden of patients and adjusting the medical insurance reimbursement policies in the local area. Methods　Using the total health expenditure accounting data of Hainan Province in 2020, including the outpatient and inpatient data of 14 provincial medical institutions, 235 city and county level medical institutions, and other relevant data from the 2020 Hainan Statistical Yearbook and Health Financial Yearbook, the direct medical costs of tuberculosis patients in the province in that year were calculated, and the influencing factors were explored using single factor analysis and multivariate generalized linear model. Results　The final number of cases included in this study was 11 979, including 7 526 males (62.83%) and 4 453 females (37.17%). The total direct medical costs of patients were 43.207 3 million yuan, of which the total outpatient costs were 2.733 9 million yuan (6.32%) and the total inpatient costs were 40.473 4 million yuan (93.67%). In the cost composition analysis, the drug cost was 17.971 million yuan (41.44%), the examination cost was 8.854 7 million yuan (20.49%), other costs were 16.445 5 million yuan (38.06%), and the median (quartile) M(P25,P75) direct medical cost of each patient was 177.50 (66.73,764.89) yuan. The multivariate generalized linear model analysis showed that hospitalization, new rural cooperative medical insurance (NRCMI) and urban employee medical insurance were the influencing factors of the increase in direct medical costs of tuberculosis patients the median (quartile) M(P25,P75) of direct medical costs are 10 425.04 (6 560.87,17 374.9), 10 246.5 (5 871.28,17 220.33), 3 177.2 (293.09,7 730.23) yuan respectively; the OR(95%CI) values were -3.505 (-3.499- -3.517), 1.559 (1.551-1.569) and 2.191 (2.188-2.207) respectively. Conclusions　The direct medical costs of tuberculosis patients in Hainan Province are high. Hospitalization, the new rural cooperative medical insurance and the medical insurance for urban workers are the influencing factors of the increase in costs.

OBJECTIVEThe efficacy of rate and rhythm control strategies for treating atrial fibrillation (AF) patients was analyzed in this meta-analysis.

METHODSEligible trials were searched in MEDLINE, the Cochrane Library, the Clinical Trials, the Chinese VIP database up to May 31, 2010. Ten prospective randomized control trials with 7876 patients (rate control n = 3932, rhythm control n = 3944) were included for final analysis.

RESULTSAll cause mortality (5.3% vs. 5.0%; OR: 1.03; 95%CI: 0.84 - 1.26; I(2) < 25%) and incidence of worsening heart failure (3.81% vs. 3.61%; OR: 1.04; 95%CI: 0.80 - 1.36; I(2) < 50%) were similar between the two groups. Subgroup analysis showed that all cause mortality (3.6% vs.1.9%; OR: 1.89; 95%CI: 1.01 - 3.53; I(2) < 25%) and rate of worsening heart failure (2.3% vs. 0.3%; OR: 5.6; 95%CI: 1.44 - 21.69; I(2) < 25%) were significantly higher in rate control group than in rhythm control group in patients with age < 65 years. Thromboembolic events (1.49% vs. 1.46%; OR: 1.02, 95%CI: 0.71 - 1.48) and bleeding events (1.78% vs. 1.73%; OR: 1.02, 95%CI: 0.70 - 1.49) were similar between rhythm control and rate control groups while rehospitalization rate was significantly lower in rate control group than in rhythm control group (17.56% vs. 22.98%; OR: 0.37, 95%CI: 0.19 - 0.71).

CONCLUSIONThis meta-analysis shows that rhythm control strategy is superior to rate control strategy for AF patients with age < 65 years in terms of reducing all cause mortality and incidence of worsening heart failure.

Arrhythmias, Cardiac ; prevention & control ; Atrial Fibrillation ; physiopathology ; prevention & control ; Heart Rate ; Humans ; Prospective Studies ; Randomized Controlled Trials as Topic

OBJECTIVETo compare the sensitivity and practicability of modified Bethesda assay and Nijmegen assay in detecting factor VIII (FVIII) inhibitor.

METHODSModified Bethesda assay and Nijmegen assay were used to screen FVIII inhibitors in 237 patients with hemophilia A. The buffer plus universal coagulation reference plasma (UCRP) was used to establish a standard curve for FVIII: C assay in modified Bethesda method, instead of Nijmegen plasma plus FVIII deficiency plasma in Nijmegen method. The cutoff value for positive FVIII inhibitors is > or = 0.6 BU/ml.

RESULTSThe positive rate of FVIII inhibitors was 5.5% (n = 13) when using modified Bethesda assay and was 8.4% (n = 20) when using Nijmegen assay (P > 0.05).

CONCLUSIONModified standard Bethesda assay is a convenient and feasible method for detecting FVIII inhibitors.

Adolescent ; Adult ; Autoantibodies ; blood ; Blood Coagulation Tests ; methods ; Child ; Child, Preschool ; Factor VIII ; immunology ; Female ; Hemophilia A ; blood ; immunology ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity ; Young Adult

OBJECTIVETo compare the effects of carvedilol, metoprolol and propranolol on myocardial gap junction (GJ) structure in rat with myocardial ischemia and reperfusion injury.

METHODSRats were divided randomly into five groups: sham operation group (SO), myocardial ischemia and reperfusion group (IR), IR + carvedilol group (CV), IR + metoprolol group (MT), and IR + propranolol group (PP). The left anterior descending branch was ligated for 30 minutes and reperfused for 4 hours (IR). After 4 h reperfusion, the distribution and composition of gap junctional connexin 43 (CX43) were observed by immunofluorescence and laser scanning confocal microscopy (LSCM), and the quantification of CX43 was measured by LSCM.

RESULTCompared with SO group, IR resulted in abnormal distribution and composition of CX43-GJ and the impairment of CX43-GJ was significantly attenuated by CV, MT and PP treatments with the best effect observed in CV group (P<0.05 vs. MT and PP).

CONCLUSIONThese results suggest that beta-blockers, especially, carvedilol, could significantly attenuate IR induced CX43-GJ impairment.

Adrenergic beta-Antagonists ; pharmacology ; Animals ; Connexin 43 ; metabolism ; Disease Models, Animal ; Gap Junctions ; drug effects ; Male ; Myocardial Reperfusion Injury ; Myocardium ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective:To analyze the impact of different surgical methods on perioperative complication rate after radical cystectomy in patients over 75 years of age.Methods:A retrospective study reviewed 1 432 patients who received radical cystectomy from January 2003 to January 2015.A total of 239 pa-tients were ≥75 years (median age:78 years),of whom,74 patients (31.0%)suffered one or more perioperative complications.According to the different operation methods,patients could be divided into ileal conduit group and cutaneous ureterostomy group.The ileal conduit group included laparoscopic and open radical cystectomy with ileal conduit.The cutaneous ureterostomy group included transperitoneal laparoscopic,transperitoneal and extraperitoneal open radical cystectomy with cutaneous ureterostomy. Results:Perioperative complications were significantly associated with the patient’s age (P =0.012), American Society of Anesthesiologists (ASA)score (P =0.001),node staging (P =0.043),and dif-ferent surgical methods.Perioperative complications caused a prolonged hospital stay and delayed recovery (34 d vs.21 d,P =0.002).For different surgical methods,the perioperative complication rate of ileal conduit was higher than cutaneous ureterostomy (P =0.013).However,there were no significant differences between transperitoneal laparoscopic and open radical cystectomy with ileal conduit in perioperative complication rate (P =0.836).The perioperative complication rate was statistically signifi-cant among transperitoneal laparoscopic,transperitoneal and extraperitoneal open radical cystectomy with cutaneous ureterostomy (P =0.022).On multivariate analysis,age (hazard ratio =4.856,95% CI:1.465 -16.103,P =0.010),ASA score (P =0.008),and different surgical methods (P =0.016) were significantly associated with the perioperative complication rate.Conclusion:The perioperative complication rate after radical cystectomy in elderly patients was associated with the patients’age,ASA score,and different surgical methods.Patients who received extraperitoneal open radical cystectomy with cutaneous ureterostomy suffered fewer perioperative complications,which was an appropriate choice for elderly patients.